Cost-effectiveness of speech and language therapy plus scalp acupuncture versus speech and language therapy alone for community-based patients with Broca’s aphasia after stroke: a post hoc analysis of data from a randomised controlled trial

Liu, Zhizhen; Huang, Jia; Xü, Ying; Wu, Jingsong; Tao, Jing; Chen, Lidian

doi:10.1136/bmjopen-2020-046609

Cited by 7 publications

(8 citation statements)

References 25 publications

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“…There may be other relevant perspectives (e.g., those reflecting the interests of other stakeholders who are affected by the treatment) to consider. For example, Liu et al 9 studied the cost-effectiveness of speech and language therapy plus scalp acupuncture versus speech and language therapy alone for community-based patients with Broca's aphasia after stroke. The analysis was performed from a societal perspective, including all expenses related to the interventions irrespective of who paid.…”

Section: Methodsmentioning

confidence: 99%

Analyzing a Cost-Effectiveness Dataset: A Speech and Language Example for Clinicians

et al. 2022

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Cost-effectiveness analysis, the most common type of economic evaluation, estimates a new option's additional outcome in relation to its extra costs. This is crucial to study within the clinical setting because funding for new treatments and interventions is often linked to whether there is evidence showing they are a good use of resources. This article describes how to analyze a cost-effectiveness dataset using the framework of a net benefit regression. The process of creating estimates and characterizing uncertainty is demonstrated using a hypothetical dataset. The results are explained and illustrated using graphs commonly employed in cost-effectiveness analyses. We conclude with a call to action for researchers to do more person-level cost-effectiveness analysis to produce evidence of the value of new treatments and interventions. Researchers can utilize cost-effectiveness analysis to compare new and existing treatment mechanisms.

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Section: Methodsmentioning

confidence: 99%

Analyzing a Cost-Effectiveness Dataset: A Speech and Language Example for Clinicians

et al. 2022

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“…(5) Studies with experimental designs and outcome measures that did not meet the inclusion criteria; (6) Studies with unclear treatment methods and courses of treatment; (7) Studies with incorrect or unclear scale ratings or data that could not be extracted; (8) RCTs with a Jadad score of <3.…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…Some studies have also demonstrated the therapeutic effect of acupuncture combined with language therapy. [7][8][9] However, there is a lack of strong evidence to support that the combination treatment is superior to single treatments for poststroke aphasia. Randomized controlled trials (RCTs) are considered the gold standard for comparing interventions because of their greater comparability and reduced bias.…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of functional recovery of aphasia after stroke by acupuncture combined with language rehabilitation training

Zhou,

Liang,

Zhu

et al. 2023

Medicine

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Background: The aim of this systematic review is to evaluate the effectiveness of combining acupuncture with speech rehabilitation training, compared to acupuncture alone or speech rehabilitation training alone, in the treatment of post-stroke aphasia. Methods: To gather data for this study, we searched 6 databases: PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang Data, and Chongqing VIP Database. We included clinical randomized controlled trials on acupuncture combined with rehabilitation training for post-stroke aphasia published between January 1, 2011 and October 8, 2023. Two researchers independently screened the literature, evaluated its quality, and extracted the data using Stata 15.1 SE and RevMan 5.4 software. We conducted a meta-analysis using the random effects model, and expressed dichotomous variables as odds ratios (OR) with 95% confidence intervals (CIs) and continuous variables as weighted mean differences (WMD) with 95% confidence intervals. Specifically, the odds of improvement were significantly higher in the combination group (OR = 3.89, 95% CI = [2.62, 5.78]). Improvements were also seen in several language functions, including expression (WMD = 5.14, 95% CI = [3.87, 6.41]), understanding (WMD = 9.16, 95% CI = [5.20, 13.12]), retelling (WMD = 11.35, 95% CI = [8.70, 14.00]), naming (WMD = 11.36, 95% CI = [8.12, 14.61] ), reading (WMD = 9.20, 95% CI = [4.87, 13.52]), writing (WMD = 5.65, 95% CI = [3.04, 8.26]), and reading aloud (WMD = 7.45, 95% CI = [3.12, 11.78]). Scores on the Chinese Aphasia Complete Test Scale, Western Aphasia Complete Test Scale, and China Rehabilitation Research Center Aphasia Check Scale were also significantly higher in the combination group, with improvements of 7.89, 9.89, and 9.27, respectively. Results: A total of 16 clinical randomized controlled trials, including 1258 patients, were included in this meta-analysis. The results showed that compared to simple rehabilitation training or acupuncture treatment alone, the combination of acupuncture and language rehabilitation training was more effective in improving clinical outcomes for patients with post-stroke aphasia. Conclusions: The results of this meta-analysis indicate that acupuncture combined with language rehabilitation training can effectively improve the language function of post-stroke aphasia patients and increase clinical effectiveness. However, further research is needed to confirm these findings and provide a more reliable evidence-based basis for clinical practice. In particular, additional studies with large sample sizes, high quality, and more specific and standardized outcome measures are needed to strengthen the evidence. The limited quantity and quality of the current studies may affect the generalizability of the results.

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“…Finally, Liu et al analyzed the cost-effectiveness of aphasia therapy provided to 203 individuals with Broca's aphasia. 31 The intervention consisted of scalp acupuncture coupled with aphasia therapy compared with only usual care (aphasia therapy alone). Cost-effectiveness was calculated using QALYs and ICERs and they found that the total cost of the intervention was €4,001.72 ($4,570.96) compared with €4,323.57 ($4,938.60) for usual care.…”

Section: A Need For Economic Analyses In Aphasiamentioning

confidence: 99%

Understanding the Economics of Aphasia: Recent Findings from Speech and Language Research

Jacobs

Ellis

2022

Semin Speech Lang

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In recent years, stakeholders engaged in the study, treatment, and understanding of aphasia outcomes have emphasized the need for greater transparency regarding the economics of aphasia rehabilitation. Most notably, third-party payers and clinicians have a keen interest in understanding the resources used to treat aphasia, particularly the cost-effectiveness and value of aphasia treatments. In this article, we review the current literature related to the economic burden of aphasia and the cost and cost-effectiveness of aphasia treatments. To date, relatively few scholars have attempted to study the efficiency, scale, and scope related to the economics of aphasia and the cost-effectiveness of aphasia treatment. While studies of the cost-effectiveness of aphasia treatments have shown rehabilitative treatments conform to established quality and cost benchmarks, the continued progress and developments in the treatment of aphasia and measurement of clinical outcomes has left many areas unstudied. We highlight the need for greater emphasis on the cost-effectiveness of aphasia treatments in addition to the traditional focus on the efficacy of treatment outcomes.

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Cost-effectiveness of speech and language therapy plus scalp acupuncture versus speech and language therapy alone for community-based patients with Broca’s aphasia after stroke: a post hoc analysis of data from a randomised controlled trial

Cited by 7 publications

References 25 publications

Analyzing a Cost-Effectiveness Dataset: A Speech and Language Example for Clinicians

Analyzing a Cost-Effectiveness Dataset: A Speech and Language Example for Clinicians

A meta-analysis of functional recovery of aphasia after stroke by acupuncture combined with language rehabilitation training

Understanding the Economics of Aphasia: Recent Findings from Speech and Language Research

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